II > I l » . "W_,. ‘*JJI‘~,RY \’ Midzigan Sum f ,- ‘IHEQ‘D u I ~‘*‘ .< “. hfi‘ WORKER-01.13??? PERCEPTIOII 0F TEE PRESENTIKG PROBLE-I £3 RELATED TO CLIEiT'S DECISION TO USE SERVICE by LESTER KAYE HADEN A PROJECT REPOET Submittod to the school of Social Work Michigan.Staturundvcrsity 1n.Part1a1 Fulfill-ans of tho Requirumonto for'tho Dogroo or L‘EASTBR OF $6111. worm May 1961 AppmmWU C tuna. Research,Camm1ttco Sinner? éék é ’ ACKHOWIBDGB 32313 With a simple word of gratitude I rich to acknowledge the sacrifices made by my wife. Joan. Which were neceaeitated by the reaponaibilitiea and long houra demanded to “plate thia project. ' The generou- and considerate help of the Fmily Service Center. Kalmaaoo. Michigan. left nothing to be deaired in providing eupport and intereat in thin proJect. hr. John V. Reid. Director. he a thoughtful oomultant in a review of poaaible areaa of etudy. Mra. Sylvia Thea and Mr. Arthur Unhington. Were. gave their time and taleota without qualification to assist by evaluating recorded uterial. Profeaaional technical advice me afforded by Mr. Arnold Curio of the School of Social Work. Michigan State Univeraity. we helped me to cubine theoretical and realietic cooaider- atione tonrd making thia effort a atinulating reeearch exper- ience. - And finally. my long time edviaer and Chairman of my Research Cmittee. Dr. Lucille K. Barber. I thank for her underetanding and support. Part I. IIe III. IV- Ve We TABLE OF OOETEMTS INTRODUCTION eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee scope of Problem Juatification of the Study Potential Value of the Study The Agency and Ite Intel-eat in the away ‘3m033 m 11907143313 eeeeeeeeeeeeeeeeee ”CKGROUIJD OF STUDY PROM. PREVIOUS STUDIEseeeeeeeeeeeeeeeeeeeeeeeeee METIUDS LED MTMSeeeeeeeeeeeeeeeeeeeeeeee Source and nature of Data Collected The Uee of Queationneiree and Caae Reeeerch Editing and Coding of Major Footed-e Sought mung Control of the Setting 13133313 IND PREMATION 0F MTLeeeeeeeeeeee 33-13“! m mucrrmxs eeeeeeeeeeeeeeeeeeee ‘PPEKDIX eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee BIBLIOGRAPHY...............................o....... 3o gfigfi Hfle 10 to Be Ce De 7131.3 0? ILLUSTRATIOfiS title Nature of the Problem ae Seen by Client and UBVROI'CI ROIICOC $0 Source of’Data eeeeeeeeeeee Cleaaificetion of the Problee ea Seen by Client and Worker eeeeeeeeeeeeeeeeeeeeeeeeeeeeee Concietent P iona of Pnoblu by Client and UDTKOI'II R 0‘ SO Contlnnlncleeeeeeeeeeee Problem aa Defiud by Worker and Client aa 3.1‘80d t0 Continuance eeeeeeeeeeeeeeeeeeeeeeeee Coneiatency of Problu Perception aa Related to Worker-Client Under-tending and lament .Among Continuere and Dlflcontlhflirfl~eeeeeeeeeeeee Coneietency of Problem Perception. It Related to Reaeon for Client 'e Decieion on Uee of . service non: Continuua and Diecontinuere u... sociel Glace ea Related to Continuance and Diecontinuance eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee Social Claea ae Related to Coneiatency of Probln Perceptiona Anon; Continuere and Diacontinnere eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee social Claae aa Related to Opportunity Afforded by the Agency Among Continuera and Diecontimere Social Glace Related to Reeeon for Client'- Decieion on Uee of Service Among Contimere Ind Diacontinuere eeeeeeeeeeeeeeeeeeeeeeeeeeeeee LN’EIHHCES Inatructione for Worker-e Claaaification of Presenting Problen eeeeeeeeeeeeeeeeeeeeeeeeeeeee Questionnaire Ind Cover'Letter eeeeeeeeeeeeeeeee Method for Detenination 0f ”Gill Claaa eeeeeee Tabuletion and Recording of Punch Card Data eeee 11 Pug. h? 52 5b 59 61 63 76 83 PART I IL‘TRODUCTIOR Win This study concerns the Mrkfl' and the family ag- ency 'e responsibility to meet client needs more effectively. Emphasis in thia study is on that area of casework practice involving client-worker recognition end definition of the client's presenting problem and its relationship to continc uence beyond four in-pereon interviews. A secondary focus relates the above to social class of the client. ' W1 Efforts to survey this problem are Wed in the in- terest of making possible greater attaiment of social case. work goals. This study is pertinent to this end in as much as it concerns the client's problem shich he presents to the funily agency. the solution of mich is the charge that the agency. lorker and client must mutually acme. This investigators inereet in this study problm stone frus a desire to test and reveal the significance of meeting the individual client here he is in his perception of his presenting problen. This is considered one measure of the opportunity afforded by the agency. which influences the cli- ent's decision to use service. -2. W It is anticipated that the findings of this study could have theoretical value in formulating hypotheses to test causal relationships betveen worker-client perception of the presenting probles and the type of client. the nature of the problu. the opportunity afforded by the agency and client 'e environment in regard to how these factors affect the client's decision to continue use of service. It is possible that the findings of this study may be of practical value as a back- drop sgsinst' which to evaluate agency policy. practice or ad- ministration related to intake. the waiting period. the fee , A schedule. staff development. community education and public relations. The Funily Service Center of Kalmeaoo. liichigen. where this study is to be carried through. is interested in this area of research. Primarily. their interest stems from a gen- eral desire to examine and evaluate agency process and caseer practice kneeling the inherent value of self examination as a foundation for future growth and planning. AW personnel has expressed their belief that the focus of this study is related to certain agency Operations. and as a result the findian might have value in several areas: (1) is an indication in determining whether revision in intake procedure is necessary. (2) To determine. in pert.lhat uhatetti- tudes exist within the cannunity tourd the agency. (3’ To gain knowledge of causes of client non-acceptance of service offered and to determine the degree to Which the agency is meeting client need. (1.) To determine who are the clients of the agency and the implications of this for oteff educa- tion and public education. (5) To have an additional basis for evaluation of the administration of the agency fee sched- ule. (6) To determine what problems are presented and the implications of this for public educntion. Past agency study efforts. related to this investigator's survey. have been in the area of study of the nature of cli- ent's problems. The agency has many times been swore of cli- ent discontinuance during the study phase and has been inter- ested in determining why. One approach in finding ensure to this has been to engage in cursory study of cases to determine community attitudes about the scency es s reflection of the nature of problems brouqcht to the agency. PART II ASSGEPTIOHS1LHD BYPOTHESIS The general assmptions upon which this study is based is that continuance is a function of client motivation and opportunity afforded by the agency and the clients environ- nont. Also. that that opportunity involves. «the other things. tut vex-her and client perceive the presenting prob- lee consistently. Such perceptions it is some can be deterained no: the recorded date of the "intake. intorviosP sndfrutherosponsesofthe clionetoaqueetiennsire ‘urVCYe A highly definitive hypothesis is not being tested here because of the paucity of theory Ihich wold lend itself to pin point causal relationships between sentiments and worker-v client perception of the presenting problem. However. inhero out in this study proble- is an iapliod hypothesis. It is that a slim Iith activation bill decide to use agency sor- viee beyond four in-person interviees if there is a mutually consistent perception of the presenting problee by the client and lurker. providing that restrictive factors are not present. It is also believed that factors of help expected and nature of the problem as they are related to consistency of percepto ions will influence continuance. In via of a secondary focus related to social class. the data of this study he correlated with social class of the client. ~5- i‘erns in the above hypothesis will no! be defined. m: Any adult in the county served by the Kalanasoo Family Service Center who presents a problem for which on going service till he nads available and is offered, and share the individual does not refuse service during intake. More than one individual in the sane fanily nay be consid- ered a client if the above criteria is fulfilled. WI When a client indicated a desire to be helped and indicated drive in the direction of solving a focalised problu. Clients in need of continuing service we elect to receive more than four in-person interviews. W! The client's Question at issue proposed for solution. (That focelised issue with mien he vent. help.) W8 01mm and writer emu-ted astobeinagreuentonthe natureofthe personal. inter- personal. or enviromental situation Ihich poses difficulty for the client and client and uorker agreement on how this difficulty affects the client. (This later point means hes the client sees his problan. Ihich in turn is a major influ- ence determining that vith ihich he ants help.) Wt These are construed to mean anything involved in the client's decision to discontinue use of needed agency services. These may be internal factors (such as lack of motivation or confined expectations of help slanted) or external factors (such as restrictive enviromental situation. lack of fmily support. improvuent of problem situation. or negatively perceived mience with the Iorksr or uith agency as regards fees. waiting period. stod. PART III PREVIOUS STUDIES W Social workers responding to their professional obli- gation and their human desire for accomplishinent have almys undertaken efforts to serve those in need in the most con- structive manner poseible. Caseworkers in an effort to in— prove end define practice have studied their clients. thus. selves and their interaction in regard to problem solving. They have been concerned with the skills and setting they - have to work with. how to use their skills and setting and what they want to accomplish. The aeans of problen solving hes been thought to be as important as the and solution many times. However. if solution or improvement does not occur or the person with a problem doesn't use the service available much concern has been on the question. IWhy?" In regard to those who are in need of service and the have had contact with fueily agencies. but decide not to use the service. much study has been done. A recent study by Gui-in. Verofi‘ and Feld. of how “Ameri- cans View Their Mental Health.“ focused on the individual in the general population. They studied attitudes toward aental health and problem solving patterns of groups asking up the American culture. The implications dram fru this study. to be useful in planning for mental health, were in the area of -8- psychological. cultural and educational influences bearing upon the Amsrican public. Particular emphasis was put on the fact that it is the individual who is the Judge as to whether he needs help. This relates to whether his needs are felt, and it is “felt“ needs which this national study recorded.l Hatching felt needs with resources is a challenge requiring solution on many levels. This study added verifi- cation to a study of "Social Class and Mental Illness“ by Hollingshead and Radliok which paints set also the disparity of uniform treatment or treatment facilities for different social classes.: representing of course different cultural orientations with varied perceptions of need and adsptative behavior. The study by Gurin. at al.. involved factors relating person (client) and resources. It did not concern itself with what goes on in the treatment process or its results.3 Certainly many do not find their way to a treatment re- source. but of those we do find their uy to a family agency only a minority continue in treatnent.‘ It is here. at this V 7 Curin, Gerald. Joseph Veroff and Shelia Paid. W how rorkl Basic Books Inc.. . pp. ' e zfiollinjshead, August and Frederick 3.41m, W (New York! John Wiley & Sons, 5 . pp. : - c5 . acurin, Veroff and Paid, m. p. 1.01. LKocan. Leonard 3.. mm. Short Term c... in a Family twenty! Th: Stud 'me' W V010 33s 3°. 5e (HIV. 1957). Pa 2 2e level. that agency and staff are concerned with serving those me actually seek out a resource to whm they present their problem. We must be concerned first with those in need who nuke contact with a family agency, but do not de- cide to use the service, before we seek out an increased or select clientele who may also be in need. Of course, every client who comes to a family agency for help will not choose to make full “use of the service.‘ Factors within the agency may act as detriments to the cli- ents' use of the service. Studies of these phenomena have fallen into two general categories: those concerning the client and those concerning the worker which includes his setting and his processes. This writer. however, is not studying how well clients make 'use of service," per se. but its antecedant-continuance beyond the study phase. Stud- ies unearned with continuance in casework have of necessity examined discontinuance. Such studies have revolved around the intake process because it is at this point that a major- ity of clients terminate their contact with the family agency. Leonard S. Hogan has pinpointed that in a 192.7 to 1955 anor study at the Comunity Service Society. lid-.0... the mother of cases in the M which terminated with fewer that two in-person interviews varies from 56 to 65 per cent: in 1951. run reported a median figure of 6!. per cent.’ In a css study in 1951. it us seen that 83 per cent of cases had closed before ~10- receiving a fifth interview; when eliminating those without any in-person contacts. the figure dropped to 2Q per cent.6 F3“. in a study of eleven mt coast agencies in 1952.. showed that of those cases having at least one in-person interview, £1 per cent closed before receiving the fifth interview.7 Dr. in m of 633 has described a 191.8 FEM study of 3.1.1.1. W with fewer than ts. in—person inter-vials. Of these. 15 per cent represented service cosmpleted: 1.0 per cent were referred elsettherex and of 35 W cent who needed casework services 22 per cent had unplanned temination and the other 13 per cent were unwilling to accept a plan for further contact. The remaining cases were closed because of unlikelihood of modification or because other appropriate services were not available in the community.8 It is interesting to note that the above 35 Per cent rep- resents largsly discontinuing clients she requested service for family or personal problems rather than enviromental problems. However. in a later study by H. Blenkner of new cases Opened with an in-pcrson interview in 1%? at 833, it Elm... p. 232. 712.11.. p. 232. 8 Shyne, Ann L. "What Research Tells Us About Short Term Cases in Family A ,encies," W Vol. 38. No. 5. (HIV. 1957). pp. 23-225e no discovered that clients who asked for help with pay- chological or interpersonal problans were more likely to continue beyond intake.9 These two statements are not as inconsistent as they appear to be. . In Shyne's review of current research in several ran agencies she reports that this substantial group of clients who need service. yet who do not continue. refuse service because of any number of factors cited. such as: lack of realisation of need to participate in its solution. low sot- ivation for solution. resistance to «sender's exploration. and poor attitudinal responses of client's fully. Dr. ayne questions whether caseworkers fortify these barriers to con- tinuance. axe says that clients and writers have noted an inability of the writer to seat the client on his own ground. allowing his to develop his problea as he sees it. and as- plaining in a iny he understands the kind of service being offered. as sell as conveying seas encourageaent about the possible helpfulness of the service offered.“ Moreover. differences in the social class of the worker and client is suggested by mayne and others as an obstacle in finding a semen ground toward enhancing the worker-client relationship. Of the multitude of factors bearing upon the client which results in a decision not to use agency services. this v Blenkner. Margaret. ‘Predictivs Factors in the Initial Interview in Emily casework.” W Vol. as. NOe 1. (March. 195‘s). Pa 7°e “sum. Moe pp. 230.231. -12. researcher is focusing on the client 's presenting problu: that is. the worker's and client's perception of the pres- enting problem as related to the client's decision to use agency services. It is felt that this is one way to seas- ure the opportunity offered by the agency. The theoretical framework for this study grows out of Lillian Ripple 's re— search at the University of Chicago wherein the preposition examined us “that the client's use of service is detenined by hiaaotivation. his capacity and the opportunities afford- ed his both by his enviroment and by the social agency fro: tmioh he seeks h.ip.11 Before elaborating on that study. 1 should like to re- turn to Kogan's research at 688 on short tars cases seen at intake during one nonth in 1953 and then review George Levinger's aethodology for studying continuance. Xogan dif- ferentiated his suple into planned and unplanned closings and studied and cupared one in-person interviews with t!» to four in-person interviews. In conparing the unplanned closing with the planned closing. he found that there are sore significant similarities than differences whether there is one interview or two to four interviews before closing. However, those who continue beyond one interview. but not over four. have slightly sore interest in working on their problea and are sore resistant than planned closers to IIliipple, Lillian, "Motivation, Capacity at Opportunity as Related to the Use of Casework Services Plan of Study." VOls 29. NOs 2. (m. 1955,. Pa 1730 .13. exploration of their problem. They see their problem as a family or relationship difficulty but attribute it more frequently to others than themselves. They also appeared to like the worker better.12 In surveying workers and for- ner clients on route up. he found that workers tended to attribute discontinuance to lack of interest or resistance. Yet, half of these clients of follow up showed disatisfac- tion with either the progress made or disatisfaction with the worker. These clients also showed that the other most ccmon factors associated with discontinuance was either an improvement of the problem situation or an inability of a prscti cal environmental nature which prevented continuance. By contrast. the worker ascribed discontinuance to possible improvement or practical factors in only about 10 per cent of cases. Also. the unplanned closers tended to have more complex problems than planned closers. The former were less likely to have seen their problems emerging during the first interview}3 A framework for studying continuance has currently been suggested by User:- Levingerol" He has stated that 'contin- uance or discontinuance is viewed as behavior in a situation ”Kazan. Leonard 3.. I"i'he Short Tens Case on a! Family Afllzlggfid’m 11.. figififinmfl, VOle 38. “Ge 6. (31811.. y1957’s Pa e 13 .‘The Short Tern Case ina Agengg-o Ps7? ”1.. 5 cial Casework, Vol. 38, No. 7. l1'(July. 1957). 1"’Imringer. George ”Continuance in Casework and Other Rel inn Relationships ‘ Review of Current Research.' m M. VOIO 5. We 3. July. 1960’. Ppo w'SOe inhabited by the (client) and the (worker) in a relation- ship." Thus. it is assumed that the (client's) behavior depends on the characteristics of (the client), the char- acteristics of the (worker). and the nature of (their) relationship. And it is assumed that the behavior of both (client and worker) is a function of their personalities and their environments. It follows, he indicates, that (the client's) continuance in treatment is a function of vari- ables in the following five areas! (client's) personal attributes, (client's) current environment, (worker's) per- sonsl attributes. (worker's) current environment, and the characteristics of the (workeroclient) relationship.“ This researcher's focus on the W falls in the first of these areas: namely, the client 's personal attributes. However. a study of worker-client perception of the presenting problem would seem to fall into the later cat- egory of characteristics of the worker-client relationship. Such a frame of reference as Levinger proposes would probably be useful in.a study'wdth.a rigorous research design. But since the nature of this writer's efforts must be considered basically empirical, Levinger's framework is inappropriate and of too broad a scope for this small research project. Now, I shall return to Ripple's work on motivation, cap- acity. and opportunity, part of which us related to the nature of the client's problem.” Theoretically. she postulated Igfiipple. Lillian and Ernestina Alexander, 'IJIotivation Capacity, and Opportunity as Related to the Use of Gas Services Nature of Clients Problem." ' Vol. 30. No. 1. March, 1956. ‘thtt the client vith W and adequate capacity to when the WW ., n. , _, ,,.,,-...,_. ,4 Hm . . ._.._ .., .. J- .. W in a positive sense that the client would not make 3» of agency service. Incidentally. 'use of service" she quantitatively observed by neasuring umber of in-person interviews: continuance being five or more. The previously stated frane of reference provides an em- anination of continuance as a function of four general vari- ables: the client 's motivation. his capacity. the opportunity afforded by his enviroment. and the oppwtunity afforded by the agency. This frane'sork. I believe. provides for a effic- iently methodological approach to studying writer-client per- ception of the presenting problem as a function of Ripple's fourth variable! the opportunity afforded by the agency. It should be clarified that Ripple 's fourth variable includes two genera concepts: first. that services offered are apprOp- riate: and second. that the services are supplied in an adeo quate manner (resulting in the client's deciding to m case— work help). This researcher's study is primarily concerned with this second concept. but am tilt in the study sample the service is appropriate for the client 's need. B(ii-13131.0 Mn Fe 171.. -l6- Use of service of course assumes continuance; however, continuance is not to be construed as efficient "use" of the service accepted. Moreover, in attempting to correlate cone tinuance with a'workerwclient perception of the presenting problem we must realise that worker-client understanding enp hances their relationship and continuance gssgmgs a good relationship; but. we cannot yg§_aay that mutual understand- ing of the client's presenting problem is a necessary ante- cedent to. or results in, continuance beyond four interviews. The findings of this survey should clarify this. Ripple's findings are oriented to her problem classifio cation scheme. Before outlining her findings, it is important to understand the basis for her problem.classificstion scheme. The scheme is not based on pathoIOgy because this represents cause and not the presenting problem. Her definition.of prob- lem is a "question proposed for solution!. Therefore, since casework is a problem solving process the foundation of the classification scheme rests on two general concerns: First. a concern not with aggregating problems. but with that quest- ion which is identified by client or caseworker or both as requiring solution; Second, a concern.not'with describing a problem, but with describing broadly the inpperson situation as this has relevance to common elements of problem solving. ”Otherwise. they developed a system that would contain a relatively small number of'mutually exclusive categories which describes the problem situation and the client's relationship .17. to it...” laassapest faete fashion. sheds-«up problem cats- goriea based on content of narrative statues” made by Judges of the client's problem. There are two guest-u. classes of preblass. In one the question for solution in- velved external. Mental. oaladjustmente or deficien- cies and. unsuitaatly. the problsa solving process contains sees M ef acting upon that environment. In the other class the envirementhasasiserplaeeiatheeuestion for solution. The first and second classes are tersed 'enteresl' and “psychological." respectively. mm each of these classes there are four definitive categories for classifying the presenting treble-.13 This classification scheme is be- ing used in this investigator's study and is outlined more definitively in Appendix A. Ripple presented her findings in relation to the div- ision of whether the presenting problem (as Judged) is eastern. al or psychological. The external proble- presented for solution is any cases existed along side a psychological problea. but the latter was not Med for solution. Concerning WW tho twang-19 showed that differences between these thst autism and do not are distinctly related to the realities of the alien's Wm Alexander. 33. 33... pp. 394°. ”me. no 1.0-kb- 19mm lilliea. ”asters Associated with Continuance in W es" mm. Vol. 2. Ho. 1. James-y, 1957) Pa e .18- enviromental situation. the client's motivation. and one aspect of service-oits appropriateness. In regard to capes- ity. Ripple states that 'eur analysis to date indicates that in these cases the client's capacity for problem solving andforuseefcaseworhhelpappearedtobeunrelatedte continence or discontinuance.'20 However. among those that c. teatime capacity is suggestedtebeiaportantastom the client uses service. It as also found that continuance and discontinuance can be differentiated in tens of the client's envirement alaost totally. Centimers were those whose housing or uploynent opportunities were mm, but modifiable. Discontinuere were these these enviromsnt fie restrictive and modifiable.” Ripple associated with continuance the client 's motiva- tion in terms of hope that his (her) problu can be resolved: and that the client 's efforts tonal prole solving have good direction and strength measured in drive. Also she found that if the client is seeking an appropriate service this factor is positively associated with continuance. Hegatively associated with continuance he the factor of lack of discon- fort on the part of the client.“ was in marine finding- W m presented, Ripple reports that the two groups, Psycho- logical and External. were very similiar as regards general 1511131. cm- mg. -19. variables associated with continuance or discontinuance. However. the specific nature of the general variables dif- fered when problns were psychological. That is. environ- ment was important as to the role played by others. The support of others in the family toward resolution of the problem ens positively associated with continuance. The con- verse ne associated with discontinuance as was also indif- ference or when no specific role was defined for others. Motivation was positively related to continuance when client was seeking changes in “ye of acting and where service is 'clearly' appropriate. Motivation. and therefore continue ance. was weekly positive if neither of these two factors were present if. however, there were no other negative factors inhibiting continuance. associated uth discontinuance was poor drive or seeking of inappropriate service.23 In developing a composite or the above factors on the basis of their relationship to continuance. categories favor- able and unfavorable to continuance were defined. It us then seen that the ratio of clients in categories favorable toward continuance produced 8 out of 10 continuers among those pre- senting external problems; it was 7 out of 10 among those in favorable categories presenting psychological problems. In both groups. external and psychological, 1 out of 10 in un- favorable categories continued.“ Such a relatively high 53m" pp. 89-90. “m. ~20. rates of continuance suggests that Ripples factors assoc- iated with continuance or discontinuance possess a good deal of reliability which supports their use in this survey. Since Ripple found that appropriateness of service is positively associated ttith continuance. this investigator sought to verify this and also study other variables which are considered as measures of the opportunity afforded by the agency, including primarily worker-client perception of the presenting problem. It should be pointed out that Ripple 'e study compared the nature of the presenting problem with continuance and found that there was a definite association between these two factors. Half of external problem group and a third of pay- chological problm group continued beyond five interviews.” This suggests there are factors related to the client 's prob- lem which influence continuance other than those studied by Ripple. This investigator attempted to get data directly frcn the client regarding his perception of his presenting problem. rather than using a Judge's evaluation of the client's prob- lem as Ripple did. This approach is taken in consideration of Kozan's studies, mentioned previously. that point out the dis- parity between the reasons given for discontinuance by case- worker and by client on follow up. Also this approach was Ripple and Alexander. 193. me. p. 1.8. .21. taken in consideration of edventages suggested in recent studies26 of using preceded instruments when clients are accessible. Ber”such-e.1 Edrar F" Pevid Fanshel, end Henr' Hover . ~ P r‘ (Jew Yoxki Pussell PART IV IIETI‘DDS MID MATERIALS First. data use obtained representing the worker's Judgement of how the client saw his problem. It seeped that the best method for acconplishinr; this use to go directly to the intake worker and provide him with closed case records for reading the initial interview. The worker as also pro- vided initially with instructions and criteria for classify- ing; the presenting problan utilising Ripple’s scheme27 as . contained in Appendix A. Because of the limited availability of time and personnel it was obvious that rigorous methodolo cgy would not be possible. Since two workers classified problems of clients known to them. it was felt that infor- mation regarding "restrictive“ continuance factors obtained from workers would be biased and therefore such data was not gathered from the worker. but instead from the client. Basic- ally, then, from the two intake workers data were obtained regarding the nature of the presenting problem and the clients' relationship to it. The other type of data needed cane from the client. which was collected using a questionnaire. See Appendix 3. Object- ive material relating: to socio-economic characteristics was ”Ripple and Alexander, M" pp. 3.8-1.5. .22- collected in this fashion. meective data as also col- lected by asking for attitudinal and descriptive responses Ihich would enlist a degree of positive or negative respoue. or provide for a selection among multiple annex-s. The client's subjective responses it as felt are a re- flection of perceptions of the client in row to (1) his presuming problua and his relationship to it. (2) arter- client understanding and aye-sent. men is a measure of opportunity arm-cu by the em. (3) his experience an: the shinistrstion of service as regards how appropriate ser- vice see-e to client shich is a measure of opportunity also. (1.) his thixicing that influenced his decision on another or not to soothe» to use agency casework service. vhich is a neesure of netivstion and opportunity. and (5) not help client expected. ‘ its points or mrther mlaination of the above pere- greph sou necessary. First. it is “Mid that certain atti- tudinal (Ho. 1 above) data will constitute a basis for class- ifying, a client 's perception of his presenting problu. Be- cause the intake workers' classifications In W W regarding the cliem 's presenting problem are oriented to Ripple's descriptive classification scheme, it is believed that this will provide a common base to measure writ- er and client consistency in perception of the problen pro. sented for solution. .21.- Ssoond. Questions regarding worker-client understanding; and agreement are included to act as a verifying; check of. as well as a control of, com-non fectors related to the work- er-client relationship which nay influence client's decision to continue.” The Questionnaire Como attempted in general to seek out factors to measure nature of the client's problsn his activation. the help expected, the opportunity afforded by the agency and client's environment. and the social class of the client. finch factors have been mentioned in the previous paragraphs. These factors are related to specific question- naire inquiries as follows: (1) . (A Measure of Opportunity Question 1. sought to determine if the client he satisfied with the practices or services of the agency to have an in— citation of shether or not the client felt that the agency service lee immune to his needs. Questions 17 and 18 sure secondarily used to this end also by attempting to inter- pret responses in the frusuork of “appropriateness“ free the client's «mint. Later paragraphs give editing and coding. rationale for 'approprieteness' . fiver-1m, Helen R. 'Inteke and sons Role Considerations.' W. Vol. do We be (£9111. 1960’. Pa 1730 -25- (2) z : Evan-w -m N -. *1 ma m 1.. o, :3. won . *3: - .1 ' insure 9 out 3 no ivst on e 6 9pc uh ty . o '1- by Ravi r-onnent end Agcnc 5' Question 17s we basically used to neck out the client’s reason for continuing or discontinuing interviews beyond the study phase. Quentien 16. was s check on Question 17. to the extent that the former could be than to evaluste the kind of help expected by the client which night shed more light on their mecca for continuance or discentimmnee. Editing and coding information for these rectors is found in e later see. 1310:: c: this report. (3) ‘ 3"” , m .' ' '1. mail! "" in! ". ..s‘-~'; ”ee' “ MW 9: won ,ty 4 o 2' gene? ' 57h “rkerl Questions 2.3. sought to deter-nine whether the client's resc- ticn to the role of the sex-kc:- uas generally positive or neg- ative. Editing and coding ct these responses is included in mother section of this pert. “5’ i1; P19! . ism ‘:..1 .IA 1: .n Measure 0 9 nature cc Questions 6-16. ettenpted tc seek date wich could be used to categories the presenting problen es seen by the client in ' - :fll .._; u; as .g; . f G l'rc‘i zen either of are major categories each including: four sub- catemries. The method of minim: this deta is included in sncther section cf this part end in Appendix A. ‘5) Education and Occupation (1 ”ensure of Social Clean) Questions 19 am 20 sought occupational end educational data vhi ch sec machined with respondents address to detemine sccisl ~26- cleee according to a formulation by Hollingeheed end Ramon.” Editing Ill! ending 1. deecribed in the next section of this part end Appendix 2,. Data eecured using a questionnaire and closed ceee reo- orde represented 35 cliente. The total member or respondente numbered 36, however one response wee incomplete. The study sample, lumbering 110. wee mailed a questionnaire under a cover letter. (See Appendix B). About 28 per cent or the ample were continuers mile 72 per cent were dieeontinuere. 0f the 35 respondents. 31. per cent me continuers while 66 per cent were diecontinuere. It wee hopefully anticipated that returne nuld umber about 1.0 per out after folleu up by telephone: hovever reeponlee Domed to 33 Per cent of the eenple. ‘ Pro-testing he done on 26 oliente with a preliminary questionnaire. Responses on pretest ran 1.2 per cent or 11 out of 26. Individuele who received the questionnaire in the pretest were picked among cliente who had intake with a former worker. Particular attention in: paid to getting e. spread on the preteet eemple according: to the time they made application for aervice. Here discontinuere (60 per cent) than centimere (1.0 per cent) were included in the pretest sample. The greatest difficulty in using a queetionneire lies in the poeeibility of receiving a limited number of returns for igfiollingeheed an Redlich. M" pp. 389-397. .27- anelysis. Therefore. to offset this limitation it was felt that by pre-coding the questionnaire to determine identity of the respondent. social class end problem data could be related to specific individuals instead of relating data to Just numbers of individuals: thereby improving the specu- icity of the findings especially in regard to worker-client consistency in the perception of the presenting problan. The closed case records were used to detemine the nature of the clients presenting problem as Judged and classified by two intake workers. The closed records contained a face sheet and complete detailed information of. at least, the intake interview. Subsequent interviews were generally of the sme- nary type. The intake workers did the recording of the init- ial interview following intake but before the client was seen by an assigned caseworker. This period fluctuated from days to weeks. The sample records. because they are closed cases. wereheldbythevorkeruntilthe closingstumryvas dictated and then the case file was stored in the closed record file: wherefrom the majority of the ample Vere obtained. In a very for cases the records were obtained from the worker assigned to the case became the closing emery had not yet been dictated. The intake worker read the initial interviev and. if nec- essary. subsequent interviews in the study phase in order to make at global judment of the client 's presenting problem as the client can it. (See instructions to the intake worker in Appendix A) .2 8.. limitations inherent in the records and worker's orien- tation may have influenced the workers Judgment. A small number of the records had a minimal amount of recording of the initial imeryiew which would act as a handicap to easy classification. However. since the intake worker was class- ifying a problem of a client when he (she) saw in intake. the worker's memory or impressions should have aided appreciably in nakinc a better founded decision as to the classification of the client's presenting problem. A realistic limitation presented itself in regard to sufficient time available for one of the intake workers who agreed to classify about 80 per cent of the sample. Since this was an additional responsi- bility in an already full schedule there existed a possibil- ity that the pressure of time may have limited full study and evaluation of data regarding: the nature of the client's pre- senting problem. The evaluation of first interview data and classification of the presenting problem by the intake worker was supervised by the researcher until the worker indicated familiarization with the process. Prior to and during the process of making Judgments when rationale for classifying selected problems was discussed extra emphasis in briefing the two workers was on the fact that the problmn to be classified is that issue with which the client m help at the end of the first in- terview. Em. a woman complains about her husband's behavior and bemoans their relationship. but says she .31.; to be able .29. to improve her eatrafaailial opportunities: or. a nether can't stand her daughter and m auething done about the daughter's cleft lip. The first ample usually would fall in the psychological probl- eategory as maladaptive behavior instead of conflict in interpersonal relationships and the second would fall in the external category.bothbecause of mum-mu- --_ ..... . This naureherreadeachrecordintbea-pletedeter- mine the nose and address of n.m.ne‘.ch.uw ‘of‘ir' person new”. the opening and masses... and ram (described in the section on sapling) whi'ch'represent' reason for excluding a case free the sample. _ . Aschedulewasnotusedto atraotdatafrutheamle case records. However. and a 5 «1-4.... used as a punch card for recording and tabulation of (ceded) questionnaire responses and workers classification of the probl- presented. and shelled the clients we and address and another he sentin- uedernotbeyondfmrinterviews. Datafruthepuneh eerds m.“bulatadonaua»ardataaum; fwusein creating charts showingkindad frequency of variables. (See Appendian) i. The 'appropriateness' of agency service as seen by the client «mam a album" Judssnent by the researcher of previously aentioned questionnaire responses. This Mgenteallaforthe codingofreaponsesintoeneof three possible categories: (1) Service Highly Appropriate. .30. (a) Service Satisfactory and (3) Service Inappropriate. Category 1, is essentially positive. Ihile category 1 is negative and category 3 nixed as regards the attitude of the client toward the agency as an appropriate source or help. The rationale for classification into these cats. geries (the editing process) is as tells-s8 W the client checked that there need he no change in agency practices or services enddidn’tqualiryhis response inanyhy. Also. the absence or any disparaging remarks turd the agency he noted in the questionnaire. WWW-U110" the dim checked that no change should be made in agency service or practices. but qualified his attitude by indicating that a change should be made. er indicated displeasure aildly in only one aspect of his agency experience. 0r. share client indicated a change should be node. out put this in tern of positive suggestion rather than negative meat. Or, where the question no not answered and negative attitudes or cements were not discernsble anywhere in the question- naire. Wmelientdidnotanmrquest- ionorcheckedthstachangeshouldbensdeandalsoin- dicated displeasure turd the agency policies or prac- tices. .31. 3. The folloling relates to factors developed from client “reasons for continuance or discontinuance" and I'help expected." The reasons clients gave indicating what nade then 'decide whether or not they would continue to use cmnseling services" after the initial interviews were listed beside the I'help client expected to receive.“ This listing of responses to than edited and coded. In general the coding is related to the purpose of ques- tions asked: i.e. to seek an indication of the oppor- tunity provided by the agency and the client 'e environ- nent. and the client is motivation. Contixmsrs' responses were coded to fit into a two category schemes (1) Motivation and (2) Opportunity afforded by the agency. The rationale for editing re- sponses to classify according to this echue is as follows: We" client indicated personal need and de- sire (with drive) to be helped. * Wm client indicated an attitude mich represented a response of confidence in the agency and] or worker. These two categories are not mutually exclusive: hosever one factor usually predominated over the other. There seaned to be no responses on questionnaires that a category could be created which would represent the -32- influence of the cliente' enviromental opportunity among continuers. ’ Diecontinuar's responses were coded according to a five category scheme: (1) Agency limitation (2) Re- lationship limitation (3) Enviromental limitation 0.) Lack of activation (5) Relieved or helped. The rationale for editing responses to classify according to this schue is as follows: Wars the client discontinued because of a realistic limitation in providing service as needed| e.g.. long uiting period. W'" the client discontinued because of dissatisfaction or diners-ant with worker or workers nethode. We” the client discontinued because of physiological, distance or transportation obstacles. or because of familial non-support toward using counseling help. W the clients' response showed lack of desire to work on probl- or become personally involved. Wm." the client discontinued because the problem was satisfactorily handled by client. or more there the relief, or where the client indicated he felt sufficiently helped. C. .33. These categories are not mutually exclusive be- cause the naturs of this data is inherently overlapping: however. classification was based on subjective Judge ment of more client seemed to put emphasis. Category number 1, Z and 5, represent the nature of Opportunity provided by the agency. number 3, represents the nature of opportunity provided by cliente' envirousent and number 5 represents the nature of clients motivation for using casework service. Category 5, represents dis- continuance based on “sufficient“ help having been re- ceived indicating opportunity was afforded by the agency. The factor of ”help expected“ as indicated by the client seemed to be 'logically‘ related in.some cases to reasons for continuance or discontinuance. toreover. the 'help expected' responses sided in some cases to the interp- retation of the meaning in corments about reasons for continuance or discontinuance. The creation of coded categories which would describe a relationship between the reason for continuance or discontinuance and 'hclp expected" was not attempted because of the extent of non-specificity betweennthese two factors. In listing the responses of ”help expected" for coding purposes, the focus was on creating; categories which would indicate the general kind of help expected. The categories cre- stcd‘were (1) Personal Help or Counseling (2) help An- other (3) Budget or Material Service U.) Advice or Information (5) Did News Know. Theratiansleforeditineresponsestesid classi- fication into this sehaae fellows! Were client primarily W W soaslhelp forselfandthereisasaeindicstionefthe worker bein seen as having a counseling role. Wu. wommlcmwumpbv easing megs inanstherwheaayeraaynet initially have esataetwith agency. Orwhere client eapectehelp by a dieeuesien of attitudes and behavior of another. Wr- ths mm W agensywill help inproeuring funds senatorial services 01‘ lid) 13 “Ms W 011m urea" agency to provide advice or intonation. and this is supported by an indication of non-involveaent of self. wmm indicateehedid netknusr he at me what help to expect. The fate of 'client-Woster understanding and anreuent' was developed free questions which sought to detenine whetherarnetthe client perceivedthewsrksre roleas basically senatrucuvetolnrdtheendefwsrltingto- gather on client's problem This is felt to be one sees- ure of the opportunity afforded the client by the agency. Responses were coded into three categories; i.e.. Distinctly Positive, Slightly Positive. and hostly F. senative. Editing us based on the following classi- fitory rationale. W eve-um «use you or no answers and eaplanitory ments were distinctly posi- tive and/er me descriptive mtenants of a neutral nature were node in response to questions. Were positive responses appeared in greater degree and kind than negative responses. Wm see-tin responses w a. greater degree and kind than positive responses. The faster of the “presenting probl- at issues. as seen by the slim. with which he tasted help' is determined frea eleven questions. Since these questions were based on requirements of classes as established frca Iiipple's classification schace (See Appendix A). it he felt that the responses would give indication to the nature of the problem in such a fashion as to facilitate classification by the Ripple aches. . Therefore on this basis the responses were edited to determine first if the problem could be classified as psychological or external. Then editing of responses further provided for sub-classi fi cation. The reticule for editing was siniliar to that included in Appendix A... The factor of “social class" as determined in three «tops.3o First the occupational. educational and residence data was coded using three separate schemes to develop rankings. Second. the rankings were placed in a formula to get a total rat! score. Third, the raw, scores were compared to the Bollingshead distribution of total scores to determine position in one of five social classes. Refer to Appendix 9 for the coding eats- gories. . , Specific mention should be made of editing residence and occupation data. For residence. the block of the street more the client lived as given to a public of- ficiel of Kslasasoo who as familiar with social and housing coMitions in the city. He ts able to asks a global Judgment of the quality of housing in each case: thus obtaining a ranking. Also. a local realtor opened his files to this researcher so that using sarket values of the house. or houses adjacent to. where the client resided it no possible to assign an alternative ranking of the residence: again according to the schools in Appendix 52. The average of these two rankings. obtained thru the public official and the realtor. us then used as the final ranking of the residence in question. The editing of occupation was based on data of the clients' Job title and type of business. here this ”mug“ m 3““. Ms. ”De 390.396e .3 7. information us not clear. the closed record file and the city mam provided information. this research- erbeoauseofpriorpersonslknwlsdge ofthenaturs ef various businesses and Job descriptions was able to asks a global Judgment to rank the occupation of the priaary are or salary earner in the client‘s family. ‘ Additional analytical information of transposinn raw ecu-es of social position inte Social Class position is found in Appendix 9,. ' n. The factor of I'contimaance or discontinue“ he deter- mined by counting the umber of interview as recorded in the case file. Ceding the client as a contimer is done if there were five or more inopersen interviews. and as a discontinuer if these tiers fewer than five in- person interviews. The first interviss us altars held at the agency. mun: ‘ A isanplingaethodvas saployedteselect unitsto be ex- .insd in the total universe. The W sgple represents all “uses lads. in a specific tins span except for (1) ex- clusions fru the universe representing cases that have not been closed, and (I) pertinent exclusions fro: the retaining e-ple. The universe represents about 331. 'cases aade' mich were opened tith an in-person interview in the period 5-1-59 thrs 10-31-60. 'casea aade' actually represent more than 33!. clients because more than one person in a family nay be considered a client. 'Caees node” are generally those cases more an application for service has been received and con- timinz service offered. except for the following: where service is complete in one interview, where decision for on- going service has been left with the client because the client lads no decision during intake or, where the service requested to inappropriate to the agency. Within the total universe. the initial sample involves only those cases thich have been closed on or before lO-Bl-SO. Of the 33!. "codes me" m were closed by this date. A certain curator of the 131 closed cases had to be excluded fru the initial suple because they Vere reopened (l2), or had M closings at the fourth or earlier interview (8), or were service was cunplete in two to four interviews (5). or had insufficient data recorded (17). or had moved to an un- kns'n address (12). or where primary client was a teenager (5). or more service use later deemed inappropriate (2). or where referral of the client was subsequently made (3), or there client no considered incapacitated for purpose of responding to a questionnaire (6). or then a client who had experienced intake with a worker who had resigned from the agency (31.). Of these latter 31.. 26 were used in the questionnaire pretest. The lumber in the {in} sample use 119, with included 22 spaces or others who were considered clients in a "case made" (M1Y’ e .3 9. Sons of the criteria for inclusion or exclusion frua the final test ample. needless to say. were not nutually exclusive. Vhen the selection was completed there were 12 cases (individuals) in the group having four or less in- terviews and 1], cases in the group with five or more inter- . views. a total of m in all. These may be generally des- cribed as adults me made one application for service. for whu casework as deued an appropriate service. and who continued or intended to continue with interviews beyond the range of one thru four interviews. W This is a study of worker and client problem perceptions of clients who were offered and needed service and who con- tinued or disooztirmed using service. Therefore factors wish influence continuance or discontinuance aust be controlled. The prinary control is exercised by cmparing Miners fru the suns universe as the disoenticuers. however. only about half of the W fron the universe are represented in the test sample. The cases in the test saaple could be con- sidered representative of the universe W W. That is. a study of most of the clients as shoes: to be secluded in the section on sampling would be in- appropriate with thepurposes of studying contixmance as it relates to perceptions of problans. moreover. of the 99 ex. eluded oases free the initial sanpls only a minority of about «L0.- 30 per cent of these exclusions were made for reasons which mld result in a somewhat skewed pm sample. I refer specifically to those exclusions where there is a paucity of recorded dots and where the client discontimed and concur- rently planned to more to a residence unstetcd or unictem- ined. Fan)! cases in this universe were active and therefore not in the sample: however. the only basic difference between active and closed cases is the time differential wherein the majority of sample cases represent clients who come to the agency during the earlier part of tho eighteen months and the naJority of the yet sctive cases came to the agency durins the later pert of the eighteen months' period. Be reminded that this study in its broadest sense is e:- nining selected aspects of the W afforded by the agency. However. the administration of and practices within the agency relating, to the fee schedule. waiting period. assigment to caseworker after one intake interview. the characteristics of workers, etc. presumebly affect continuers and discontinucrs. Therefore. the specific influence of such factors on continuance or discontinuance may create differ- ences between continuers and discontinuers which epcrate in an uncontrolled fashion thus influencing the findings to an unknown degree. f Significant factors influencing continuance such as activation or environsent of the client. as studied by Ripple. are not adequately controlled except for attempts at a general determination with the questionnaire of the possible presence or nature of such factors. PART V AIIAL‘ISIS KID PRESEEITATIOH OF 13AM The results of this study are based on.” clients out of a couple ef no who responded to a questionnaire survey. These results are stated briefly in the following paragraphs. followed by a presentation and interpretation of tables of collected deta. . Of significance as the finding that Ihere perceptions Vere inconsistent between client and when the client al- most alt-ye discontinued. And. almost all centiwers had a oasistent worker-client perception of the presenting problem: tuner. half of those with consistent perceptims discontin- ued. here than one out of four adult clients. in need of and accepting ongoing service offered. continued beyond four in- person interviews. A little more than three-fourths of all clients set their presenting; problems as psychological rather than external. Where problems were seen as psychological by “the: client 9; intake worker, about one in three of these clients centimed. Data .8 too sparse to develop a finding regarding; continuers with external problans. Where a client's problem was seen by the lurker as psy- chological. half of these clients saw their problem as being in a di fferent psychological category or as an external prob- la. however. there he a much greater consistency in writer- 4.2- .53. client perception of external problems of 'diclocetion' con. pared to "maladjustment.” when clients experienced other measures of opportunity}1 afforded by the agency only the clients who also had consist. ent perceptions continued in half of the cases Where both of these factors were present. inane; cases of inconsistent per» captions. over half had been afforded Opportunity yet almost aluys they discontinued. All clients Who were Jud-cod not to have been afforded opportunity discontizmed. where client “expected personal counselinc' 7 out of 10 respondents continued among those with consistent problem perceptions. These 7 clients also prevented psycholosticnl problems and felt opportunity was afforded. Those edth cons sistent perceptions of the problem uho expected help of a different nature other than personal counseling usually dis- continued. The continuers were those clients who 'decided to use service" because they had.notivetion.usunlly combined with opportunity afforded by the agency. Data was inconclusive in differentiating; nature of opportunity afforded by the regency from restrictive factors in.the client or his environp neat in.rclation to discontinuance. Continuance rates generally appeared similar rcnardlees Slgflmnity here refers to a positive type response to the combined factors of 'understandinz and agreement" and 'apprspriateness' of servi ce. ef eecial claae.32 However. percentageuiee clients in the top claaa ae compared to the bottom clue are more likely to diecontinue'vhen perception: are inconsistent. A greater ratio of bottom than top claee clients had consistent per- ceptions; however thia didn't appreciably enhance the contin- uance rate of bottom claae clients. Curiouely. there me a greater’rate of inconaietent perceptions‘of problena (7 out of 12 or 53 per cent) none: top elaea oliente (all in Clan 111) compared to cliente of the bottae claeaea. About three-fourths of the clients of both top and but. claaeee felt opportunity he afforded by agency; moreover. a eieiler ratio of the clients in the bottom once (6 out of 1b) continued.ae compared to the top class (5 out of 13)‘Uhen opportunity lae afforded. Perecnal counseling help Iaa expected to a little greater per eem none olienta of the top clue (7 out of 16) ea con- pared to clienta of the bottom clan (7 out of 19). Data no not definitive tmrde ehoving a relationship between thia expectation and continuance among cliente of different claeeeeo The client'e mm for continuing ae made by thoee in the top claeeee nae etated ueually in tame of motivation. In Blue V it vae etated in terne of opportunity that had been afforded by agency; in Claee IV it was stated in tenne‘of eotivatien. "Tm , , For purpoaee of atating results, social class usually refere to_tvo groupings: Top claae. referring to Claee II and In: bottom class ”farting to Close 1? and V. There ia no data for Glen 1. .55- Anong the“ Who decided not to use aervice the data than no trends differentiating; reasons for discontinuance on the baeia of aocial clean. The foregoing he: been en.account of the more aignifi- cant resulta developed from the data collected. An.evalu- ative diacuaaion.ef these resulta aupported by pertinent tablea Hill now be attempted. The reoulta of thia atudyilere developed from data ob- tained fron.35 respondenta. aoueverg deter-aa'aleo collected regarding characterietica of the teat aanple in relation.to (l) continuance and.(2) Iorkera definition.ef the preaenting problan. In respect to theae two factora the data of the aenple should be compared with that obtained from the respond, enta aa a baae for Judging validity of major findinnra to be diamaaed eubeequexrtly. within the ample of 110. 28 per cent ccutimed and none the 35 reapondenta 3k per cent continued. Thia auggeete that within the universe of 'ceaea made" a little more than one- fourth of the cases continue. Alec. it should be noted that the above percentages indicate a greater tendency for contin- vars to respond to the queationnaire. The extent of thia tendency ia email and therefore not thought to eiqnificantly alter the reaulta of thia study. The 28 per cent continuance rate in thia aample ia aimiler to that reported by F3“ in a 195k atudy of eleven'wect coaat arencies‘uhich ahowed that of those caeea having at laaat one in-peraon interview, El per al.6- cent cleaed before receiving the fifth intend“? 1n Ripplee etudy the continuance rate the 1.1 per cent. .The sample used in thia atudy the patterned close to that used in Ripple'a atudy." Honour. the universe from which bath ample: me taken and the different agencies: involved undoubtedly could accoum in part for the different“ in the continuance rates aentiened. ' TABLE I 13"!"an 03" T33 PROBLEM ‘3 SEEN BY CLIQW- AIZD 33:32.3 A3 RELATED 1‘0 WUECE OF DATA . M A — _ 1 L A W Source of Data and Per-eon mm Nature of Problem W W Mel W Worker 3 9%} 91%? Client 8 ini) 7;} 32:00“ 00‘; ilnnli Yorker I. (133: I 87%) no (100%) Cliem no data available no (o) W Table 2 above the predominance of problem preaented are paycheloaical in nature by whomever defined. Yet the variance betmn how worker and client define the problem should be noted. In cowering the lumber of external problema aa aecn by worker and client to Ripple'a finding. Ia aae that ehe fl ”m... Leonard 3., 'The Short Term Casei Family Agency! Thezgzudy Plan. figgial fingglgzk, vol. 38. he. 5. ‘Hey. 1957) Pa e 3"’Ripple. 195.. £13" PPO 175‘76' found that 53 per cent of clients as Judged by aorkers and 37 per cent of clients as judged by Judges‘aere thought to have presented external problems.35 These figures are more eeaparable'aith the 23 per cent above representing the clients can.definition.of an external problem. The greater number'of external problems defined by the client as compared tO‘ibrk¢ er'a definition nay be due to a worker's tendency to define certain external problems of'naladjustnent as psychological ahioh the folloling table of data infers. Therefore. we night attach acre significance to the ratio (23 per cent) or external problems as defined by the client and than study data in Table 2 to validate that about three out of {our problems presented are psychological rather than external. TABLE 2 CLASSIFICATION 01’ THE Fromm A3 3233 3? 61.1323? Lh’D WORKER ‘4‘ w Problem Seen pr: Category of Problu as Judged by Worker W In Economic or 3 3 3ocial Dislo- . cation lb Economic or 2 l l l 5 Social Malad~ Justnent Ila Interpersonal Conflict IIb Kaladaptive 2 l 3 Interpersonal Relationship IIO Other Personal. 1 I 2 ity Disturbance in Client v Ripple Ind “OHMOI‘. we Ma. Pa L7e (5 c. p C 4.3- nm a (confirmed) Prole Seen atom of Problem ae Judged by worker b7 Client Ia IbJIIa Ilb He no Total lld Pereonality 2 l 2 I. 9 Dieturbance in Another .._-L 2 Totala 3 O 15 2 8 7 , 35 ‘ In Table 1 ie preeented a detailed picture of the dif- ference and einilaritiee of eorker and elient perception of the problee. It can be aeen that there ‘ie ainilarity in where of perceptione of external probl-a of dieloeation and narked dieainilarity in m. of eaternal problem of aaladJuetnent. There ia about 50 per can aiailarity in mnbere of problem of Interpereonal Conflict and Pereena’lity Diatnrbance in Other than Client. Over half of the exterul prebleneaadefinedbytheelienteu'edefinedbytheeerku- aa mythological. Seven mythological problena were defined diaainilarly between Personality Dieturbence in Other than Client and the remaining categoriee ef paycholegcel prob- he. Koreever.‘ mm. the probl- eu «am by the mm ae Paychologicel. in half the «no the client defined the proble- in a different peyehological category or ae external. coneeqoently. it may be inferred that there ia a tendency for ecrkera to define external probleee of aaledjuetnent ae paychologicels alae. a tendency to define paychological prob. 10-: «Wu: roman-1 pubic-um «L9- .glignt. Thie‘eould euggeet that there are actually more eliente‘eho preeent external problene or’peycholegioal problem in othere than the worker definee ae euch. Thie amnion eupporta our previou- euppoeition that about threes fourthe of probleea preaented are paychologicel. It ie difficult to compare the dietribution in Table 2 eith Ripple '. diatdbutionaé ether than to eay that differ- eneee in*eorker-client perceptiene lather diatributicnueere net ea greet ea inuthie etudy. Heeever. certain.differencee ind-ethodolongIuet be borne inmnind. Firet. that nipple de» veloped her claeeification achece fr. Judgee' narrative etateeente*ehich*eaa annattenpt te»liat and drelrent criteria for eetabliehing a.elaeeification.echene. Geneeeuently. her och-e en created free the thinking orientation of vex-k." 'Ihareaa. in.thie atndy the echanefieae iapeeed~ever'the orient- ation of the earlier. Alec. there ahe need trained Judgea to detenine the clienta' perception of hie problee. thia etudy atteapted to obtain.data.directly free,the client‘lhich eeuld he*ueed to determine the problea.according te prearranged eriteria. Therefore. linitationa of the aouroe‘and differenoee inwaethedelegy'ef collecting'data.conld account tor'a.dieto~ ribetien Ihich variee fr. Ripple'e. It ia more likely that thia varietion otene fro. the application of Ripple 'e echeee la.a.teeting aituationnuaing”lnrkara like thia inveetigator thanare unakilled in.profeeeional eocial lurk reaearoh and "m. a. \li eho had the job of becoming familiar with the scheme and applying it to the intraciee of each individual case. fiejor findings as embodied in Table 3 end cubcequcnt tables will now be discussed relating consistency of per- ccptions, and other rectors associated therewith. to con~ tinuence. TAELB 3 COI'ISISTEKT PERCEPTIOIIS 0? 937.0915}! BY CLIP??? mfg) Wang“ ‘3 LcLirau TU Cbhflhchhch Problem Goon as Similar b; F Per Cent " e , M W -""'“ W W EconOmlc or Social 3 2 1 67% Dislocation Psychological other than below 16 7 9 th Personality Dis~ turbance-other # 2 2 50; than Client TOtfl‘ 23 ll 12 L511; *— M Table.) shoe! that When perceptions are consistent a little less than half of the clients continue.- However. data is not conclusive enough to indicate if continuance rates would be higher among external or psychological problems perceived consistently. the rate of continuance seems significantly greater when psychological problems are perceived consistently as compared to the nature of the problem es being psychological! -51.. the former being about one out of tee and the latter being one out of three. That onedthird or clients with payche- locical problem continue will be substantiated in Table be This data would suggest that continuance is more directly related to consistent perceptions rather then to the nature or the prohlun. especially as regards psychological prob- lens. ' Other data not em in not. 3 on significant) an (n) the clients use problem as seen by worker and client much Vere not classified so as both perceptions fell into the same categocies as above almost al-ys diecontinced save one. Therefore. these findings infer a definite association between inconsistent perceptions and discontizmsncet and also suggest that consistency in perceptions is associated sith continence and is necessary. but not exclusively so. for en- hancing continuance. In a {aliasing discussion tables will be presented be- ginning with Table 5 which will relate consistency of per- ceptions to factors or opportunity. motivation. help expected. nd social class to dstsxuine what other factors have a sig- nificant role in influencing continuance or discontimnance. War. as have previously referred to substantiative data in Table 5 that concerned the nature or the problu as related to continuance ethich should be discussed briefly at thds point. .52- um t PROM 13 ENE!) BY VORKER ARI) CHIEF! A3 RELATED TO CORTIRULRCE Contin- Discon- ) Contin- Diecon- W MMMIMAM. iimm Icononicsraocial 3 t l 3 2 l Dislocation Economic or Social Per Cent contimiing 35g 675 Psychological other 18 7 ll 25 8 17 than below Personality 01.9 tux-uncouth» than .11.” W W Per cent Confirming 33% 31$ as can be seen clients Iith psychological probleess by sin-ever defined oentimed in about one-third of the cases. Thistiadiuussupportedtrcadatefrcathellosuplecaeea msemflfluflpercentetclients continuedvhe Isrs thought by the m to have had presented psychological prshl-s. Aleciathetuel ssapletheverkerdefinedu clients' preueas as mernal or onion 3 continued or :1 per can. 1: workers have a slight tendency to define eater-ll prehlus as psychological. then in reality there are fewer psychological prohleas than the 96 seen in the total ample -53. as Judged by the worker. Also since clients with psycho- logcal problme seen to contimie more often than those sith external problas. we could suspect that clients presenting psychological prohlans will contizme at a rate mouthst greater than 29 per cent as has indicated in the total staple. The data in Table I. is inconclusive as regards the con- tinuance ratio among clients thought to have presented eac- tcrnal problems. Reverthcless, data in the total sample sug- gests that continuance by clients presenting external prob- lem occurs much less frequently as compared to clients pre- senting psychological problem. One reason for this is offered in Teble l. and 2: that is. clients she define their own external problem as mladjustment are seen by workers as presenting psychological problem and these clients almost always discontinue. a sinilisr situation occurred within the subocsteszoriu of psychological problems. then problems by Mover defined were PsycixolOgicsl W client the continuance rate us about one out or four. Hherees, in other psychological sub- categories the continusnce rate was in excess of one out or three. Reference to Table 2 shows that over half of the clients who defined their problem as psychological W the writer defined as being in a different psycholoztical cate- gory. This my be one moon for the lower continuance rate snow: clients presenting psychological problems W with mich they hated help. The foregoing shoes that slnost one-third of the clients presenting psychological problems contime and suggests that a seam number of clients presenting moral problass con- tinue. This finding is partially reversed from Ripple's wherein she discovered definitely that a greater ratio (50 per cent) of clients with external problus continued. as sea- psred to about one-third the continued along those presenting psychological protlus.” In regard to such findings Ripple concluded that there 1. a and» association bots-ea the nature or the problem and continuance. I We cannot conclude here a definite association batman the nature or the problem and continuance because there is insufficient data involving clients with external problns. Other factors shioh say influence continuance then re- lated to consistency of sorter-client perceptions sill not he discussed. mm 5 60153131331613 OF PROM! PERCEPTIOS AS RELATED TO woman—cum UNDERSTAE-IDING AND lGx’ififiéEHT M4086 CONTINUES MD DISCONTINUERS Contin- Discon- l'er Cent lull .nsn. 31mm 99mm .. Positive . ll 3 6 1.653 Slightly l'ositive n 6 5 55% V Kegative A 1} fl, 1’ 1%; Contin- Discon- Per Cent ml ma. m ‘ a. 1 3 253 Slightly Positive 3 O 3 07s Kegati vs I; g, If 4. ,7mde. Pa “a «55¢ Table 5 relates continuance to the factor of worker- clisnt understanding and agreement moor: clients with 00n- sistent and incansistent perceptions] thus using one detona- lnant Of the Opportunity afforded by the agency to Show its relationship to contizmanco. Remover, before discussing data relevant to the factor of understanding and aorta-moot, it some that definitely the most importmzt finding: in Table 5 is the positive association batman consistent? of perception and continuance Uith oppon- tunity (in the ram 01‘ uniorotendinr: and agreement) playing: a supporting; role. m. m. in‘l‘abls 5 murmur) comm..." judged to show a positive (including slightly positive) re- sponse to wrist-standing and agreement. 22 or about three- fonrths hsd consistent perceptions. however. of the 23 with consistent perceptions elnoct all of these had a positive type response and half continued. whereas. 7 out of 12 with in- l consistent perceptions who also had a positive type response discontinued.‘ Those with negative responses whether the per- ception was comistont or inconsistezn‘. discontinued. This data seem to suggest that nosntivo type moponnec is assoc- iatod With dinocntimuncc: and positive typo responses boars n ctr-on: noono-ntion Iith continuance m perceptions are consistent. Furthermore. consistent perception seen to en- hance the frequency of positive typo responses, out it cannot be ssid thet inconsistent perceptions necessarily cause ”WV. responses. worker-«alien understanding and amount “I I measure of opportunity afforded by the agency as was the factor of appropriateness of service. Date relating this latter factor to continues more; clients with consistent end inconsistent peroeptionsnsslsosnslysed. Thedataus eisilsrinits distribution to that fazed in Table 5 concept for the differ- ences in factors mined. li'he findings related thereto suggested that appropriate- neesoi’servioe is aseociatedsith ooutimanseoslyifthe perceptions of the problem is consistent. when perceptions are eminent this may enhance the clieu's reeling thet service is appropriate; m. m the perception is inocu- sieteu this does not necessarily oeuse the client to reel lervioe is iuppropriste. am in regard to these tale measures or opportunity indieeted that opportunity had been afforded to the meat as- Jec-ity or clients. but thst costimeme or discontinue“ eeuld at be associated to these factors alone. Theclienth orientationastothskindofhelp expected no conceived so having a influence on writer-client percep- tius o: the problem or continuance. Therefore. to evaluate this poseihility data use collected vouch related to these veriatleet hos-yer. since the charts sore ample: they will not he presemed. Rather the major results till be briefly -57. outlined. The data of east significance will be mentioned first. It she-ed.thatre.greater ratio oi'respondssts (it out or )5) expected personal counseling‘as compared te’other expectations ot'hslp. Ten.or'these lh.had consistent per- ceptions: of these 10. 7 continued or 70 per cost. These 7 als0>presested psychological problems and indicated oppor- tunity“sasuatforded hy'the agency. noreoverb among thirteen clients'uith.oonsistent perceptions‘lho’s:pected;g§hg:;§h.n, personal counseling only four continued. .inother significant result uncovered'ssswthat clients 'Iith expectations etggthg:;tnln.pereeosl counseling:slthough opportunityHIas afforded continued inxooly 5 out arms: cases. These results suggest that‘sheniopportunity is afforded clients‘lho expect personal.counseling'tand‘to’continual-ere- so thasxthose‘sho have other expectations ot’help. Therefore. it appears that continuancewnay'to sore directly associsted ‘uith.expectations»et'persoual counseling thanwsith.opportunity afforded.by”the agency. . ‘hore importantly; these results strongly inter'thst the aspectation of personal consoling when the perception of the pretianxis consistens‘lill.tendntolerd.a.high.ratelof’oostis» ‘usnoe. especially if the problsn is psychological in»nature. Conversely. if the probisu.peroeptiontis consistent and the client expects other'than.porsonal.counseling*se usually seen tortind.disoostinnanoe. Consequentlyj‘ss oas.strongly suggest that expectations oi’other*than.porsonal counseling act as e -53. 'rostrictive factor' turd inhibiting contixmanco amen problus are perceived sinilarly by client and sorter. ‘ro detenine the existence of other “restrictive fac- tors' inhibiting continuance or factors tdaich enhance con- tinuance. date no collected on the clients' reason for do. ciding; shether or not to use service. than reasons relate to the nature of client notivation and nature of opportunity afforded by the agency and the client's environ-ant. In table 6 those reasons are depicted in relation to continence and consistency of problem perceptions. However, for contin- uity in interpreting results a few couanta on date other than that found in ‘l'able 6 cases in order at this point. In this study of )5 clients. 27 felt opportunity was afforded th- by the agency and of these 27 only ll continued. Among these ll continuers. 7 expressed notivation as their reason for con- tinuing or alnost too thirds. These results support the in- ference that sotivation. shoe opportunity is afforded by the agency. is positively associated Iith continuance. Data no inconclusive in differentiating nature of oppor- tunity afforded by the ' agency fru restrictive factors in the client or his envirouent in relation to discontinuance. Hono- ever. generally than opportunity no not afforded by the agency. or the client lacked motivation. or share there no as onvirouontal linitation to contimiing. or share the client felt he hod received 'suffieient" help or relief the client discontinued for these reasons. .59- TABLI 6 CONSISTENCY OF PEBBLE! PERCEPTION 13 RELATED TO cums FOR 01.1%.! 05013101! 0}! USE OF SEEWICE H1030 CONTINUERS m nzscoznmcuas imimn W Intel Iotivation Opportunity I; W Wain Agency Limitation Relationship Limitation Environnent Limitation Lack of Motivation Eoliof or Helped “fl” gamma-O- “flflflfl t1... In Table 6 we look from a different vies at reasons given for continuance or discontinuance. i.e.. in relation to the consistency of mixer-client perceptions of the problem. We see that all (8) the clients rho continued because they had notivation also onerienced consistent perceptions of the problem. Here we can ouostion shether motivation loads to developing perceptions which are consistent or another eon- siatency of perceptions enhances motivation. The latter eo-a lore reasonable: however. both factors can be mutually sup- porting of one another. Moreover. this finding infers that activation is positively associated with continence. with regard to discontinuers there scene to be no dif- ferentiation apparent between reasons for discontinuance and whether the problem was perceived connictcntly. Those who dicoontimod because they were helped or relieved had more conoictont pcrcoptiono than other diceofiimcro. Emmyor, so this date is inconcluoivo. our previous infcmnco that inconsistent perceptions are associated with discontinuance stanie unchanged. TABLE 7 scam CLASS ‘3 WTED 70 603311331363 11113 31360371363363 ‘ W o r l ’ 1 Total Continue" - g 2 A 3 12 Discontimers . 10 Z Z 32 Total by Class «- I. 12 ll 8 35 Per cm Continue «- 75% 175$ 363$ 38% 31.93 Am Per Cent Commie 31," * 37$ ** *‘Ch‘. 11 & III, >2<>:<(31u. I? & v) an. influence of social c1...” ontho foregoing factors underatudylillnosbeshcm. Inconperincthetopandbottu cneuoinnue7itanuumtmmm1momio runoaboutonsoutofthroo. ihissuggoetsthatcontinuanoe iautspprociablyinfluencodbyoooielcleosoftheroapond- ants. ‘ . rehlo‘lelaoshosothatthersiaaalightlygreaterm- berofbottonclaoothantopclaasclients-ongtherespond- sets. This suggests an equality in renters in the mine EHereafter SocialClaaa'illrefortoClasanilIIas the Top Class and Class Iv and V to Bottom Class. .61- agency eeaeload among top and botton class clients. much perhaps is a reflection of the agency's “open door" policies tmrd serving the entire munity. In regerd to consistency of problem perceptions as re- lstod to social class. sane interacting data no collected as seen in Table 8. 113.8 8 $61”. 61.133 ‘3 RELATED TO CONSISTEICY OF PEOPLE! PEEuEPTIOHS AMONG CONTIRUERS AND DISCONTINUERS W W Total We 9 12 23 cont were 5 ll Discontinuers L 84 12 Per Cent Continue 55% 1.3). 1.8% Wm 7 i ll ont more 0 l Discontinusra 7 I. 11 Per Cent Continue 0)": 2055 8% In Table 8 we find a greater percentage of contimers (5 out of 9) with consistent porcoptions in the top class than in the bottom class (6 out of it). But conversely. there us a greater ratio (7 out or 16) of top class than batten class clients (5 out of 19) with inconsistent perceptions. This gives cause for an interesting speculation. Let us recall the social sort asamptiona that top class clients tend to be 'peychologically oriented" and that they tend to seek service in noro amber than bottae class clients: and further. that they discontinue in greater ratios than bottom close clients. Perhaps then Table 8 provides one reason for such discontin- uenco Within the top classes: namely, inconsistent porcop- tiono. In Table 8 all inconsistent perceptions of the tap class occurred in Class III. Those inconsistencies are pro. dominantly when the client new the problem no extoml end the worker sew it as psychological in the client. This deto sunsets strongly that inconsistencies in per- captions are associated with top class clients. and that when perceptions are consistent a top class client will continue more readily than a botton class client. He might say that because top class clients are more sophisticated they nay be influenced in continuing to a marked degree by whether they and the worker perceived the problem similarly. Conversely. although lower class clients experience a greater rate of con- sistent worker-client perceptions this does not seen to pro- duce a higher degree of continuance probably because of other restrictive factors preeminating which tend to cause discon- tinuance. ismsbly. this might be in line with Ripples con. clusion” that continuance or discontinuance could be almost totally differentiated by the realities of the clients envir- oneont and motivation. 55 , Ripple. Lillian. “Factors Associated with Contimnce in Service.“ W vol. 2. he. 1 (January. 1957 9 Po 37o .53. TAiAsE 9 3331.1... CLASS A3 BEATS!) TO 03‘POE‘T' 3111'? AFFOILnED 3'! T313 ASEICY LMOIK} COIITIHUEES HID DISCOEITIEWERS L Wad mm m Yes (Opportunity) Total 13 11. Cantinuoro 5 6 11 Discontinuers 8 8 16 Per Cont Continucrs 3873 1.37% 1.3.5 No (Opportunity) Total 3 5 a Continucrs O l l Discontinuas 3 L 7 Per Cent Continue" 09’. 20% 13% In Table 9 we nee that opportunity has been afforded top and bottom classesinanapprcuinatelyesualratios l3 o£l6 top class clients and ll. of 19 bottom clans clients. Also men opportunity is afforded both top and bcttm classes con- tinued in about equal ratios, respectively! 33% (5 out or l3) and ‘3'!» (6 out of 12.). Therefore. it appcars that opportunity Wed by the agency cannot be differentiated on the basis of social class. Data collected which relates help expected to social class should be mtlinsd briefly. Anon; the various expectations of help. only the data regarding the personal meeline expect- ation sens worthy or mention. Data showed that ll. out or 35 climts expected personal counseling. or these. 7 out of 16 were in the top class and 7 out or 19 were in the botton class. This cements that this croectation could be differentiated on the basis of social class as there some to be a 511 3;th greater tendency of top class clients to have this expecta- tion. Other data showed that of 5 clim to who e3: 99 "ten help . with others, 5 were in Clnccl II and the) discontinued. be might wonder what importance this has for the diocominnancs rate or Class III clients. Data also showed that I. of those 5 had inconsistent perceptions involving psycl-zOIOgicsl prob- lene W as defined by the client. 2W”, data relative to expectations or W pereonnl counseling; we: generally inconclusive in differentiating such expectations by eocicl class in relation to discontinuance. TABLE 10 SOCIAL “.133 RELATED TO REASOH FOR CLIEfi'r'S DECISION OH U33 OF SERVICE RIDERS 60““ VII? on: ”ID DIflOZITlisU'SELS Relationship Limitation Enviromont Limitation Lack of :Zotivntion Relief or Help Table 10 data wee collected which related eocial clue to reneonn client: gave for contimannce or discontinuance. The reader will reull thet previous findinns inferred that Opportunity could not be differentiated on the basin of eocisl eleee. Reliever. when clients gave their room for contin- ulnce it we discovered that all Clean 7 clients (A) indicated they continued because opportunity m afforded by the money. themes :11 other cleeeee who continued indicated they hsd Iotivetion for doing so. Bauer. this dots should not be interpreted to neceeeerily neon thet clients uho contime be- an» they have mtivetion have not hsd opportunity efferded them; nor does this neceeeerily neon that those who had more. tunity afforded them did not have motivation. Esther, this dete enmeete thet opportunity efforded by the sooner ie essoe- ietod with continuance mac Close V clients. hell retioe of cliente in both top end bottom oleeees diecontinued for roe-one of en enviromentel limitetion. lsck or opportunity ei'i‘orded by the egency, leak or motivetion. or because they were helped or relieved. Bee auee of the paucity of dets recoding theee teeters it ie not possible to differentiate trends relating theee reeeons for discontinusnce to eociel clue. PART VI £12513? MID REPLICATICZIG In "ties. the major findings end circumstances under Ihich they were obtained Ilill be outlined es well so the in- plicstions thereof. The findings supported the hypothesis implicit in this study which us I"'thm; clients with motivetion will decide to 3 use sgency service beyond i'our iii-person interviews 1: there is s mutuslly consistent perception of the presenting moles by the client end vorker, providing that restrictive rectors ere not present.‘ Continue" were clients we bed notivetion. opportunity efforded by the sgency. expected personsl counseling. and had consistent worker-client perceptions of psychologicsl prob- lusso When perceptions were inconsistent. or where other then persoosl consoling he expected. or where opportunity use not oxford“ by the egency or the clients enviromcnt. or where there vss e lsck of notintion. the client discontinued. ConsismW ei‘ perceptions when client hsd motivation Issued strongly essocieted with continunce especially when client expected persons]. counseling. Expectations of other then personsl counseling seated essocisted with discontinusnce. Aloe. inconsistent perceptions seemed to be stmngly socce- isted with discontinusnce. Opportunity errordsd by the scency sleee Is not deemed to be essooisted filth oontinusnce: however. -67- lack of opportunity afforded by the agency or clients envir- Onment seemed to be associated with discontinuance. The circumstances under which these findings were ob- tained could possibly lessen their validity. It Ins noted that continuers had a slightly greater tendency to respond to the questionnaire. Also, this investigator in.making sub- Jective Judgments to determine the nature and degree of oppor- tunity afforded by the agency had to give the client the ben- efit of doubt thereby tending to characterise the clients' attitudes as being more positive. A The same may be true of Judging the presence of motivation and nature of the help ex- cepted as personal counseling. The realities of utilising workers, such as this investigator, who are not professionally skilled in research to Judge the nature of the client's prob- lem according to a relatively‘unfamilisr scheme may have in- fluenced decisions on pr0per classification of clients' prob- loms. Findings in regard to the secondary focus of this study related social class to other factors studied. It was found that consistency of perceptions seemed more directly associated Iith continuance among top class clients. Moreover, that top class clients tend to discontinue more readily than bottom class clients uhen.perceptions are inconsistent; and that there is a greater ratio of inconsistent perceptions among top class clients as compared to botto-.class clients due usually to Iorkera classifying clienth external problems as psycholOQieal. Among bottoo.claee clients consistency of perceptions occurred at the highest rate. but continuance seemed to be more directly associated with opportunity afforded by the Agency or perhaps by Opportunity affOrded by he clienta' one vironmeat. Top and bottom classes were about equally represented among the reapondants. Opportunity afforded by the agency. or expectations of personal counseling were found to not have any association with social class alone. no labeled top or bottola classes. The circumstances under me}! these findings were devel- oped deserve mention,for‘weiahing their validity. Referral to Appendix 0 will show that the reepoadsntc under study represent a greater proportion of middle class clients and a lesser pro- portion of working class clients than is found in the normal population. Furthermore. because of the relatively stable ee- onorny and good standard of living in Kalmam. Michigan. it is conceivable that basically working class clients have been able to advance themselves where they have been.claeeified as middle class. Under either set of circumstances mentioned the resultant larger representation.from the general popula- tion or middle class cliente mow: the respondente could in- dicate that the group under etudy'uae ekeved or else that the middle cleee client requests agency service more frequently than persons of other social classes. ~69- ‘i'he findings suggest that the hypothesis implicit in this study is a generally valid one for testing. However. for further testing the hypothesis could be modified to re- late eocial class to client-worker role expectations and the nature of opportunity afforded by the agency (includinz Prob- lem perceptions) in regard to their influence on continuance or discontinuance. Although Ripple found that continence or discontinuance could be almost totally differentiated in the basis of envirouoentsl rectors. this does not take into consideration the hmsn socisl factor of class position which yet has to he sccm-nndeted to in servim'. a total cmnity. In as much as this study was concerned with the case- workers' and agencys' responsibility to nest client need. the implications of the findings will be related to casework practice and then to the stency. A need appears to exist in examining the casmrks' cri- teria of determining: the nature o! a client's problem. Such a detemination should be based on the problus at issue with which help is wanted nth other diagnostic or causative con- siderations focused on supporting a treatment plan and estab- lishing realistic treatment goals. Meeting the client where he is in defining his problem may be more significant in re- lation to contirmance than other common nethods of affording opportunity. Further research in this area relating these factors to social class would sea to have value tmrd the end or enhancing attaiment or casework goals. .70. This study ear that middle class clients both applied for service and discontinued at a higher rate than other classes er clients and had a proportionately greater percent or inconsistent perceptions. This would give cause to ques- tion the application of the theory that middle class clients are 'peychologicelly oriented" as usually the client differed tr. the worker when the latter defined the presenting: prob— l- as psychological in the client. This suggests that per- haps social determinants of a clients' problem require more attention and evaluation by casemrker. letusrecallthei‘indingthattheengoingeaaelsadis cupoeed of primarily clients presenting Plycholscicsl prob- lus. andthstuerkingclass clients beeae 'easeeaede'to a lesser degree than their proportion in the total population. “.mandvorking classesot climatendtooontinue for reason related to opportunity afforded thu. and other classes continued for reasons related to activation. Con- seneatly. the distribution of psychological probl-s treated inlies that the agency is acting in accordance with the therapeutic role usually associated with family agencies. m. the greater inclination of middle class clients to seek service and their proportionately larger rate or discon- timance implies that agency oomunity relations are oriented turd middle class clients. This possibly could be to the detriment of the larger nubers of working class persons in the “unity as intake responsibilities could be cvertaxed from the greater influx of middle class persons seeking service. Since working and lower class persons tend to have a greater need for opportunity to be afforded then. it would see: that emphasis on affording opportunity to these persons would be consistent with a policy of serving the entire comunity. This emphasis should logically be . reflected in intake policies and it should not be difficult to classify this class of persons using address and occupac tionsl information. ‘ Adequate afferdance of opportunity is a conunity prob- l- as all as an agency concern Ihich is being tackled in different ways: for sample. interagency program to coordin- ate and consult regarding service for sultiproblem fuiliea Ibo are usually labors of the lfler or working classes. Although such inter-cency more» have nerit. this does not some the need of reviewing or readapting agency policy or practice as circumstances change total the end of serving the total e-unity. APPEEED II A r, . ., .,.< .‘ 35., _ . .1. . -,. M ‘ ,.. The intake worker is requested to classify the present. ing problem of clients who are in the study sample after an orientation by the investigator. In order to accaiplish this the writer should become familiar with the folloaing data and the content of the intake interview in the case file. The nrker should asks global Mgaents relying Ihen necessary on oonmltations aith the investi gator. lf classification cannot be made on the basis of data in the intake interview. subsequent interviev data during the study phase should be drmupon. Thetlorker should keepinmind that he is class- ifying the problem according to hot! the client sees the prob- lem Ihich with help is wanted. The classification schane being utilised has been designed for use in a family agency. It has been created and tested by lillian Ripple at the University of Chicago in her studies of Motivation Capacity and Opportunity as Related to the Use of Caseaork Service: Nature of the Client 's Problem”. It uses mutually exclusive categories classifying the 'problan-at- isaue' Ihich would describe both the W and We It 1- not Mud on pathology- Horeover. tao classes of problus can be identified! l. That in Which the “question for solution' involves external envimmental. maladjustment or defi ciences and. concmitantly. the problem solving process contains .72. shoeluentsofaotinguponthstonvire-ont. 8. That in mich onvirousontal ciromstances. per so has a ainor place in defining the 'question for solution" and consequently the probl- solving pro- cess does not involve acting upon this onvircmont. iho nest distinction is to delineate the part (person in situation) the client has played in creating the probl-e a criteria of three stages frea siaple to cuplen is offered: "int (1). there are vistias of cimstance for muthereisanobvious connectionbeteoenthedr social probl-o. their disturbed feelings about their problus and their external cine-stances. Furthenore. t r feelings are mu sith the extent of the stress“. "Second. (Y) there are people who have had some part in creating their problan or whose problems have activated underlying personality conflicts but they also reach the saga because th:{ need specific ser- vices rather than with tron ed relationships on their own personality disturbance per se... for. despite their otai part in creating the social 1.331;» not! have realistic adversity with ch to e 'Yinall therearethoseclientsvdeoserangcin pelaooanty difficulties is fr- aild to gross slogy and m aay be experiencing difficulties n social adjust-ant “so on notional disturbance or personality pro is in the foreground'. 'Uoing these three basic differenutiens. the classifi- cation sch-o divides all situations inc (1) those in Ihich thoprobl-tobosolvodisdofinodatloastinpartbyea- ternal (as opposed to psychological) factors! (a) the client is the victia of circumstance or (b) the client has contrib- uted substantially to the creation of those cirmstsnoosi and (8) those in teach the prole is one of interpersonal relationships or personality disturbance“. Each of the above an groupings are subdivided into four categories as follow: (1) airman. A. Econasic dislocation 3. social dislocation c. Botanic aaladjustaem D. Social aaladjustaont (a, ”it unis-3m interihilial conflict or B. Maledaptivo inst-personal relationship c. Personality disturbonco- client Do :hl'M‘Y ‘1me other than this at. W! A victim of circumstance (see above I). W: The person who» behavior or attitudes have crea or saucer-bated his difficulties (see above 2). mi The problaltobesolvedisliaitodtoobtaining nore name for” ordinary maintenance. hereover. there does notsoastobeanoodtohelp clientinplanninghutouso his financial resources. 8 The problen arose because of a charm in the f-ily or vidual'o situation taxich requires planning with the client or his family to effect an at to the c circusetances over and beyond finan al assistance or the use of special resources not commonly available to or used by the culinary fanily with a moderate insane (o.g.3 hue-maker or cup placement). The following are definitions in the psychological probl- grouping of categories differentiated on the basis of lather or not there is a relatively defined focal aspect of the prob- l-andwhatthataspectis. between scornorepcroonoi" f. necessarilyviolom in attire but rather that there is reconnised difference and dim between individuals. -75. . - . ”i 'fhesameasabovo but no overt co 5.5.5.3 overprotoctive mother or acting out child (actinc out to meet unconscious emotional needs is not considered overt conflict). fit-”W "" S'”V‘~'-‘"AI' i" 53W!“ t F0333? "I ‘5'".- awffiltflzfiiifi. . ' 0 person with pervasive .. m wpt vs bohav or re at . to a focalisod question presented for colu- ticn. Behavior may be mild, heuevor. 7"? A L. "' t PETE?“ . st; ”‘0, - 9’33; m ”i come as above. ut at ute to ~> at in another person. APPEIIDIK B FAMILY SERVICE CENTER 814 ‘5". Kalamazoo Ave Kalamazoo, Michigan Re: A Study of the Services of the Family Service Center Dear This letter is written to you to ask your help in a study we are rmking of our methods. Some months ago you had a problem.which you :nought to the Center requesting help. By answering a few questions about your experience with the Center you can help us discover ,mproved.weys to assist individuals in solving their problems. This study will be successful only if you will be kind enough to :omplete the attached questionnaire. The information you will furnish rilil‘be of more value than that which we could obtain from.your. onfidential record. The questions are designed to obtain information elated to your experience at the time you had your first interview t the Center. The questions are general and therefore you will not sad to recall specific details. You willsee that of the questions a be answered, directions show what questions need not be answered. Be assured that the contents of the questionnaire will be aspected for its confidentiality; yet, your signature is not required. I shall be most pleased to have you participate in this study 1d ask your consideration in placing the completed questionnaire in L6 mail on or before Tuesday, February let. A self addressed amped envelope is enclosed for your convenience.’ Sincerely, Lester K. Naden (In charge of Research Study) I I e O t O APPEIDII‘I 3 QUESTIOFNIIRE (Requesting information which will be used to determine ways to better serve those who come to the Family Service Center) 1. Based on your experience, do you think any of the practices or services of the Center should be changed? Yes No 2% Please explain the change, if any, Wiich you believe should be made. i...— ;W fl. ‘ .7 w v .- The following questions ask for information, as you remember it, at the time you began your interviews at the Center. 3. Did you feel that the interviewer understood your problem? Yes No Other Comment w e - .\ \ N.- 4. Did you feel that the interviewer understood you as a person? Yes No OtherComment [—— _H -._.“ 5. fibre you in agreement with the interviewer's method in helping you to Werk toward solution of your problem? Yes No _Other Dormant 3. In your own words, state briefly what was the major problem that Drought you to the Center. F— '__ v w W 7. In general, did you feel that you wanted help with (1)Pcrsonality >r relationship problems OR (2) Difficult personal, home or work :ircumstances? (l) or‘TQ) If. y-"5>,u.'bb.e.cked answer-(1),. efflucstion number ’7', skip oués'nb'né; Ebola "I‘\~ e ' 3J’Uffi‘you feel”th%t ybur’problem situation, which brought you c lanter, was caused from events or circumstances over which you had is control? Yes, I was a victim of circumstance I was not a riotim of circumstance " 'e If’you answered Yes to question 8, did you feel that your reaction :0 being a victim of circumstance caused other problems which you >rought to the Center seeking help? Yes No vwvv— .0. If you.answered No to question 8, did you feel that you were not a victim of circumstance because you had a significant part in resting the circumstances? Ice U Wop l. If'you answered Yes to either question 9 or 10, did you want help with a problem situation that upset your normal role at home or ork causing you.excess discomfort in your :eletir- hip to others? '95 No -77- APPEIIDIX 3 12. Was your rimary concern when requesting help to find a solution for the need or more income for ordinary living expenses? No Yes or Yes, for ordinary expenses pIus past unpaid bills 15. If you checked either Yes answer in question 12, did you want to learn how to make better plans for using your money? Yes No If you checked answer (2) in question '7, skip questions 14 thru 17. 14. Did you want help with disturbing personal feelings and/or with a disturbing relationships you had with another person? Yes No 15. Did you want help with a definitely recognized individual difference? Yes No 16. Did you want help because there was overt conflict between ou and another adult over a definiteiy recognized individuai dii'i'erence? Tee No 17. Did you primarily want help with a problem which you felt existed in another person? Yes No L8. Please explain what helped you (at the time of the beginning Lnterviews) to decide if you should make continued use of a family lgency service. ._t Wfi l‘ 9. {That kind of help had you expected to recieve at the Center? ~ —_‘ 0. We would appreciate the following information about the prhmary age or salary earner in your family. ob Title ype of work L. Please indicate the number of full years of schooling com leted r the primary wage or salary earner in your family. Years .. e- magnum c METHOD FOR 237323312: 7152} OF 53-31511. CLASS Using a femulstion by Rollins-tamed and Redlich in their study of Social Class a rental Illness, it is possible to determine social class from the characteristics of education. occupation and residence. ' A. .- . a. A five catezory classification schme, improvised for the greater Kalsmasoo area, is a basis for rating residences o from the finest to poorest hates and ranking them along a l to 6 point scale. as follows! W (Rank 1 to 1.9 points) The best hues on spacious lots in the 'best sections“. or estates! $50,000 and up is curt-em market value. W (W 2 to 2.9 points) New suburban homes: or top grade apartments) or elder homes in “socially desirable' area or “goal" school district. Lots are well landscaped and buses contain 6 . 8 rows; $39,999 -- $25,000 is meat market value W a new 5 «- 6 room home usually mortgaged on lone: term basis: €23,999 - $17,000 current market value; or A rented good quality two family home or a good apartment; or A modest older bone of at least 25 years with 6 . 7 rooms located in good residential aresthere lots are smaller*than Category II and less‘well landscaped'with.houses built closer to the street: $l6.999 - £15,000 current market value. * a “ (Rank 8 to b.9 points) One family owners of b~5 room small houses: 913,999 . $8,500 current market value: or M or three multiple family homes in working; class section.of the citye ln.suoh dwellings ownsr*nay live downstairs and tenant upstairs. mu (Rank 5 to 6.0 points) The worst kind cf'housing; eogo. crowded or blighted areas or very old flats next to aideulk. Outside the city there are some who live in make- shift homes without sewage facilities and usually located on unpaved roads. 3. W (Rank descending 1 to 7) This is a modification of a classification systu used by the U. 3. Buresu of Census developing seven occupa- tional categories as follows: i. Executives and proprietors of large concerns and major professionals. 2. 3. L. 5. 5. 7e .81.. I'anagers and proprietors of meditm-sised businesses and lesser professionals. Administrative personnel of large concerns. owners of wall independent businesses and semi-profess. ionals. _ _’ Orners of little businesses, clerical and sales workers. Skilled workers. Susi-skilled workers. Cnskilled workers. .30 W (Rank descending l to 7) This scale is based on formal education of varying degrees broken dam into seven categories as follows: 1. 2. 3. h. 5. l U. 7. Cmpleted graduate professional trainings. Completed standard four year college course to obtain a degree. Partial college training of at least one year. High school grachmtion or less than one year of college. Partial high school-oat least completed 10th grade. Junior high school-«t least completed 7th grade. Elmentary school-ole” than 7 years of school. W Ilollinzshead provides a formula for coaputing an estimated social position score which was used in this study. For exuple, -g_- the three scale Furl-tings and constant values ass: . .od the Residence factor, Occupation factor and Education factor*sro combined in the following: hypothetical case. Judred m ' ‘ " W” ‘” “‘~' 217nm Residence 3.5 X 6 21.0 Occupation ' I 9 36.0 Education 3 1 5 1539. Index of Enu’Social ?osition Score 72.0 A rsnco of such rsw'scoros was created and using as a guide (1) the breakdown points used by Eiollinjahcad and (2) the principle of honoroneity of distribution: this researcher estimated the break off points between classes as ohown.belOU. Elna 3.212: 1:»... If. 21.2.11 Soc :3 I ‘C. O O I 23-31 2e? II 1.1.53 ’e Hes II 32-55 9e8 III 53.?L 11 . 3Leh III 55-56. 18.9 I V 8 5-113 3.0 31 .3 1V 87-11 5 {’3 e1. v 111.421 _2 21.0 1? 115-131. m 32. 1.00.1 100.0 * Three of the 35 respondents wore spouses of rcopo.donts and therefore not included. A??ZILIK D T1213? «1331.3.TI03 L33 13.31.1313: OF 133.3333}! CAILD UATA Informstion retardinz oifiht factors was punched 93.8 8 x.5 card for easy tootlation.on to a master sheet. Trans- i‘errim data from the cards to the W m included herouith required for simpli it; tr o use of the following“ key. 1. Problem Judged by Worker as - External Ex Psycholorical in client PC Poyoholoticsl in one her PO II. Frohlnn Seen by Client as - External En Porchclo1icnl in cl mt PC Psycholozical in.anotho P0 III. ZlSCOxztlnuance or C02 :tinnnnce beforlia' A, In... a fit .L at ’3 Continuance C Discontinuance D IV. reason for Continuance or Discontinuance lpportunity 0 AL elationnhio ninitntion EL Environmental Limitation EL Lack of ”otiration ’3 E;eliof or help I -514,- V. fielp Client Expected Personal Counseling Kelp othcr Budr‘et. or I‘aterial Service Advice or Information Didn't Km VI. Appropriateness of Jervlce As Seen by Client Hi~hly Appropriate Jatisfactory In.Appr0priato VII. Cliontderker Understanding and Acreament Distinctly Positive Sliehtly Positive Karativa Lastly VIII. Jocial Class of Client Upper Class tpper Riddle Fiddle Yorkinq Lower 5" :53 AI mi .00 00¢ WPUNP 0‘33 119... 5§5§fi8°°°“°‘“’“”“ 16 Tabulation of Data on Master Sheet W l n m I! 1 Pc PC c )4 PH PC Pc C M DEC 90 P0 c 0 pH yo to c M pH PC Pc 0 M PH Pc PC 0 0 DK PC PC 0 0 PH Pc PC C M PH re re c M PH Ex E: C M M3 Ex E: c M M8 PO E: c 0 M3 PC N D RI. DK PC Pc D I PH to Pc 1: AL PH PC Pc 1: m. u PC PC D EL PH Pc Pc 1: I no Pc PC 1: I u PC Pc 1: m A: PC PC D LM DK :0 P0 1) I no P0 P0 D 31. DE 90 Pc 9 u. PH P0 P0 D IN H0 to P0 1: m. ox P0 P0 1) 21. PH rc to n m no P0 P0 D AI. H0 pc P0 1) M. pH PO E: D EL DK pc I: n n. no PC I: D I AI PC Ex D 12-1 PH Ex 1:: n n. ma Shaving Eight Factora on Thirty-Five Caaoa #+§O+O O ++OOO ++++O+OOO§O+OOOO++OO+O+ a +0 +I +IOOOO+1 +440§OO| O+O¢O++O++OOO+O E E a—ruwuwwwma-wmma-t-ur no?“ ”U01“? #3” NF «PMUUU‘ N N BIEJOGRLPHY m David. and Mayor Henry. 1 . f Ruoaoll Sago Foufi‘ttgn. Gurin Gerald Vex-off Joaoph and Fold Shalia MW Bun min. mo; 15W Hoiiimshead Auruat. and Rediich. Fredrick. Wu " John 3119? m 30:13. 19 0 Mn Blcn‘mor Ear-gmt “Predictive Factora in the Initial Inter- uu n runny (Sun-m.- . .. .3 ~. 1m. 23. :30. 1. March. 19“. Kazan. Leonard 3.. "In. Short Tom Cm in a Family Agency: The Stud Plan. Part I Part II and Pm III a a w WV '33.:19'5‘30m7315m'MI-IAJ'1, 9' a “finger Com-go, ,PContimAanco in Guam-k and 0th» Hal ring Relationahipu A Rat-int or Currant Ramon." W Yale 5. KO. 3. JJIY. 195°. ’ Purina. Halan. no. “not“. and Sam Dela Conflict.“tinny!I W Volt. Ll. Do. 1.. April, 1950. Ripfio. Lillian. "Motivation. Capacity and Opportunity as Re- tod to the Uao or Cami-k Service! Plan of Study,“ ' Vol. 29. 1%. 2. June. 1955. :_ ”actor: Associated with Continuance in Can- work 33rdco.‘ W Vol. 2. No. 1. Jam, 1957. Ripple. Lillian and ilaxandor, Brnoatino. Motivation c city. and Opportunity at Ralatad to the Use of Cumk 50w «6 Datum of Clianta Fromm,“ Social Service Radar. Vol. 3 . Re. 1. Earth. 1956. Bornut‘. Ed“. meI’ b a Q Q ~86- HICHIGQN STQTE UNIV LIBRQRIES illllllll H'IIIHI UH lllllllillll IHIHIHIWIII! Ill 31293006235620